Article

The objective of this study was to determine whether individualized
gait training is more effective than usual care for reducing mobility disability
and pain in individuals with symptomatic knee osteoarthritis. DESIGN: Adults aged
60 yrs or older with symptomatic knee osteoarthritis and mobility limitations
were randomized to physical therapist-directed gait training on an instrumented
treadmill, with biofeedback individualized to optimize knee movements, biweekly
for 3 mos or usual care (control). Mobility disability was defined using Late
Life Function and Disability Index Basic Lower Limb Function score (primary);
mobility limitations, using timed 400-m walk, chair-stand, and stair-climb tests;
and symptoms, using the Knee Injury/Osteoarthritis Outcome Score at baseline, as
well as at 3, 6, and 12 mos. The analyses used longitudinal mixed models.
RESULTS: There were no significant intergroup differences between the 35
gait-training (74.3% women; age, 69.7 +/- 8.2 yrs) and 21 control (57.1% women;
age, 68.9 +/- 6.5 yrs) participants at baseline. At 3 mos, the gait-training
participants had greater improvement in mobility disability (4.3 +/- 1.7; P =
0.0162) and symptoms (8.6 +/- 4.1; P = 0.0420). However, there were no intergroup
differences detected for pain, 400-m walk, chair-stand, or stair-climb times at 3
mos or for any outcomes at 6 or 12 mos. CONCLUSIONS: Compared with usual care,
individualized gait training resulted in immediate improvements in mobility
disability knee symptoms in adults with symptomatic knee osteoarthritis, but
these effects were not sustained.

Langue : ANGLAIS